How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $933.25 | Professional | None | $741.31 | $741.31 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,230.27 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $1,047.13 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,698.24 | $2,137.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,187.76 Median $2,290.87 Typical High $3,467.37 | Facility | None | $2,187.76 | $2,290.87 | $3,467.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Select Health Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Facility | None | $2,344.23 | $2,344.23 | $2,344.23 |
Select Health Setting Professional Modifier None Typical Low $1,174.90 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,174.90 | $2,344.23 | $2,344.23 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,445.44 | $1,862.09 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,862.09 | Professional | None | $891.25 | $1,148.15 | $1,862.09 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $363.08 Typical High $467.74 | Professional | 52 · Reduced service | $363.08 | $363.08 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $190.55 | Professional | 53 · Discontinued | $147.91 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $141.25 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $93.33 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $93.33 |
Where Utah sits
The same service costs 2.8 times more in Hawaii than in Arizona. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Utah· 22nd of 51
$1,622
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.